Clinical Presentation and Surgical Approach with Review of Literature in Cases of Giant Parathyroid Adenoma

Background: Giant parathyroid adenomas weighing more than 3.5 grams are a rare type of parathyroid adenoma. They manifest as primary hyperparathyroidism with significantly elevated laboratory findings and more severe clinical presentation due to the large tissue mass. This is the first reported instance of a giant adenoma at M.G.M. Medical College and Hospital in Aurangabad.

Case Presentation: A 49-year-old Indian woman presented with a history of multiple fractures over time and complained of generalized fatigue. Investigations revealed hypercalcemia with elevated parathyroid hormone levels. Subsequently, a sestamibi scintigraphy parathyroid scan was conducted to confirm the diagnosis of a giant parathyroid adenoma. Following this, a focused surgical neck exploration was performed, and a large parathyroid adenoma weighing 6.2 grams was successfully excised.

Conclusion: Giant parathyroid adenoma is an uncommon cause of primary hyperparathyroidism and typically presents symptomatically with elevated calcium and parathyroid hormone levels. Diagnosis of giant parathyroid adenoma involves imaging and laboratory studies, with management usually involving surgical intervention aimed at complete resection. Patients typically experience a full recovery with no long-term complications or recurrence.